Factors influencing hospital readmission rates after acute medical treatment

• Published in: Clinical medicine (London, England) Vol. 9; no. 5; pp. 426 - 430
• Main Authors: Shalchi, Z, Saso, S, Li, HK, Rowlandson, E, Tennant, RC
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 01.10.2009; Royal College of Physicians
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cohort Studies; discharge planning; Emergency Medical Services; Female; General aspects; Health Status; hospital-acquired infection; Human infectious diseases. Experimental studies and models; Humans; Infectious diseases; Length of Stay; Male; medical admissions; medical assessment unit; Medical Errors; Medical sciences; medication error; Middle Aged; Original Papers; Patient Readmission - statistics & numerical data; readmission; rehospitalisation; Retrospective Studies; Risk Factors; Treatment Outcome; Young Adult; discharge planning; rehospitalisation; medical assessment unit; readmission; medical admissions; medication error; length of stay; hospital-acquired infection; Drug; Nosocomial infection; Hospital discharge; Iatrogenic; Residence time; Toxicity; Acute; Rate; Error; Duration; Hospitalization; Medicine; Chemotherapy; Treatment; Rehospitalization; Complication
• ISSN: 1470-2118; 1473-4893
• DOI: 10.7861/clinmedicine.9-5-426

It is a concern that increasing pressure to diagnose, treat and discharge patients rapidly is leading to unacceptably high readmission rates. Readmissions were studied over a two-month period. Patients were identified through the hospital coding system, and electronic discharge summaries provided details of each admission. In total, 69 readmissions were identified, representing 4.34% of medical admissions. Readmitted patients were older than those with single admissions (median age 75 and 71 years, respectively; p<0.05). Initial length of stay was greater in those patients who would go on to be readmitted (median six days; single admission, two days; p<0.0001). Seventy-one per cent of readmissions were deemed avoidable, with discharge before conclusive therapy being the leading factor implicated (56%). Readmission is more likely in older patients with complex care needs. Rapid throughput of patients is not associated with readmission. The majority of readmissions can potentially be avoided with judicious medical care.